{"id":"https://openalex.org/W2834261088","doi":"https://doi.org/10.1109/tase.2018.2847293","title":"Bottleneck Analysis to Reduce Primary Care to Specialty Care Referral Delay","display_name":"Bottleneck Analysis to Reduce Primary Care to Specialty Care Referral Delay","publication_year":2018,"publication_date":"2018-07-10","ids":{"openalex":"https://openalex.org/W2834261088","doi":"https://doi.org/10.1109/tase.2018.2847293","mag":"2834261088"},"language":"en","primary_location":{"id":"doi:10.1109/tase.2018.2847293","is_oa":false,"landing_page_url":"https://doi.org/10.1109/tase.2018.2847293","pdf_url":null,"source":{"id":"https://openalex.org/S34881539","display_name":"IEEE Transactions on Automation Science and Engineering","issn_l":"1545-5955","issn":["1545-5955","1558-3783"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310319808","host_organization_name":"Institute of Electrical and Electronics Engineers","host_organization_lineage":["https://openalex.org/P4310319808"],"host_organization_lineage_names":["Institute of Electrical and Electronics Engineers"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE Transactions on Automation Science and Engineering","raw_type":"journal-article"},"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5018562621","display_name":"Xiang Zhong","orcid":"https://orcid.org/0000-0002-6214-5876"},"institutions":[{"id":"https://openalex.org/I33213144","display_name":"University of Florida","ror":"https://ror.org/02y3ad647","country_code":"US","type":"education","lineage":["https://openalex.org/I33213144"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Xiang Zhong","raw_affiliation_strings":["Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, USA"],"raw_orcid":"https://orcid.org/0000-0002-6214-5876","affiliations":[{"raw_affiliation_string":"Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, USA","institution_ids":["https://openalex.org/I33213144"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5051718788","display_name":"Aditya Mahadev Prakash","orcid":"https://orcid.org/0000-0002-9787-2643"},"institutions":[{"id":"https://openalex.org/I33213144","display_name":"University of Florida","ror":"https://ror.org/02y3ad647","country_code":"US","type":"education","lineage":["https://openalex.org/I33213144"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Aditya Mahadev Prakash","raw_affiliation_strings":["Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, USA"],"raw_orcid":"https://orcid.org/0000-0002-9787-2643","affiliations":[{"raw_affiliation_string":"Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, USA","institution_ids":["https://openalex.org/I33213144"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5087756078","display_name":"Leanne Petty","orcid":null},"institutions":[{"id":"https://openalex.org/I33213144","display_name":"University of Florida","ror":"https://ror.org/02y3ad647","country_code":"US","type":"education","lineage":["https://openalex.org/I33213144"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Leanne Petty","raw_affiliation_strings":["Ambulatory Services, University of Florida Jacksonville Physicians, Jacksonville, FL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Ambulatory Services, University of Florida Jacksonville Physicians, Jacksonville, FL, USA","institution_ids":["https://openalex.org/I33213144"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5062993556","display_name":"Rita A. James","orcid":null},"institutions":[{"id":"https://openalex.org/I33213144","display_name":"University of Florida","ror":"https://ror.org/02y3ad647","country_code":"US","type":"education","lineage":["https://openalex.org/I33213144"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Rita A. James","raw_affiliation_strings":["Ambulatory Services, University of Florida Jacksonville Physicians, Jacksonville, FL, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Ambulatory Services, University of Florida Jacksonville Physicians, Jacksonville, FL, USA","institution_ids":["https://openalex.org/I33213144"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I33213144"],"apc_list":{"value":2645,"currency":"USD","value_usd":2645},"apc_paid":null,"fwci":0.318,"has_fulltext":false,"cited_by_count":5,"citation_normalized_percentile":{"value":0.69561264,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":90,"max":97},"biblio":{"volume":"16","issue":"1","first_page":"61","last_page":"73"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12918","display_name":"Healthcare Systems and Technology","score":0.9998000264167786,"subfield":{"id":"https://openalex.org/subfields/1407","display_name":"Organizational Behavior and Human Resource Management"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T12918","display_name":"Healthcare Systems and Technology","score":0.9998000264167786,"subfield":{"id":"https://openalex.org/subfields/1407","display_name":"Organizational Behavior and Human Resource Management"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9937999844551086,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11590","display_name":"Primary Care and Health Outcomes","score":0.9916999936103821,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/referral","display_name":"Referral","score":0.7665195465087891},{"id":"https://openalex.org/keywords/specialty","display_name":"Specialty","score":0.735702633857727},{"id":"https://openalex.org/keywords/workflow","display_name":"Workflow","score":0.6760033965110779},{"id":"https://openalex.org/keywords/bottleneck","display_name":"Bottleneck","score":0.5065680742263794},{"id":"https://openalex.org/keywords/ambulatory-care","display_name":"Ambulatory care","score":0.46659421920776367},{"id":"https://openalex.org/keywords/health-information-technology","display_name":"Health information technology","score":0.4425092339515686},{"id":"https://openalex.org/keywords/process","display_name":"Process (computing)","score":0.43688058853149414},{"id":"https://openalex.org/keywords/service","display_name":"Service (business)","score":0.42475590109825134},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.4178541302680969},{"id":"https://openalex.org/keywords/workforce","display_name":"Workforce","score":0.4175878167152405},{"id":"https://openalex.org/keywords/medicine","display_name":"Medicine","score":0.35916459560394287},{"id":"https://openalex.org/keywords/medical-emergency","display_name":"Medical emergency","score":0.3576996326446533},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.3491830825805664},{"id":"https://openalex.org/keywords/operations-management","display_name":"Operations management","score":0.28944939374923706},{"id":"https://openalex.org/keywords/nursing","display_name":"Nursing","score":0.25229084491729736},{"id":"https://openalex.org/keywords/family-medicine","display_name":"Family medicine","score":0.20361751317977905},{"id":"https://openalex.org/keywords/business","display_name":"Business","score":0.18533173203468323},{"id":"https://openalex.org/keywords/engineering","display_name":"Engineering","score":0.15785613656044006}],"concepts":[{"id":"https://openalex.org/C2776135927","wikidata":"https://www.wikidata.org/wiki/Q5242559","display_name":"Referral","level":2,"score":0.7665195465087891},{"id":"https://openalex.org/C20387591","wikidata":"https://www.wikidata.org/wiki/Q930752","display_name":"Specialty","level":2,"score":0.735702633857727},{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.6760033965110779},{"id":"https://openalex.org/C2780513914","wikidata":"https://www.wikidata.org/wiki/Q18210350","display_name":"Bottleneck","level":2,"score":0.5065680742263794},{"id":"https://openalex.org/C124306116","wikidata":"https://www.wikidata.org/wiki/Q2512965","display_name":"Ambulatory care","level":3,"score":0.46659421920776367},{"id":"https://openalex.org/C2776354556","wikidata":"https://www.wikidata.org/wiki/Q10910281","display_name":"Health information technology","level":3,"score":0.4425092339515686},{"id":"https://openalex.org/C98045186","wikidata":"https://www.wikidata.org/wiki/Q205663","display_name":"Process (computing)","level":2,"score":0.43688058853149414},{"id":"https://openalex.org/C2780378061","wikidata":"https://www.wikidata.org/wiki/Q25351891","display_name":"Service (business)","level":2,"score":0.42475590109825134},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.4178541302680969},{"id":"https://openalex.org/C2778139618","wikidata":"https://www.wikidata.org/wiki/Q13440398","display_name":"Workforce","level":2,"score":0.4175878167152405},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.35916459560394287},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3576996326446533},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.3491830825805664},{"id":"https://openalex.org/C21547014","wikidata":"https://www.wikidata.org/wiki/Q1423657","display_name":"Operations management","level":1,"score":0.28944939374923706},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.25229084491729736},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.20361751317977905},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.18533173203468323},{"id":"https://openalex.org/C127413603","wikidata":"https://www.wikidata.org/wiki/Q11023","display_name":"Engineering","level":0,"score":0.15785613656044006},{"id":"https://openalex.org/C111919701","wikidata":"https://www.wikidata.org/wiki/Q9135","display_name":"Operating system","level":1,"score":0.0},{"id":"https://openalex.org/C162853370","wikidata":"https://www.wikidata.org/wiki/Q39809","display_name":"Marketing","level":1,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C77088390","wikidata":"https://www.wikidata.org/wiki/Q8513","display_name":"Database","level":1,"score":0.0}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1109/tase.2018.2847293","is_oa":false,"landing_page_url":"https://doi.org/10.1109/tase.2018.2847293","pdf_url":null,"source":{"id":"https://openalex.org/S34881539","display_name":"IEEE Transactions on Automation Science and Engineering","issn_l":"1545-5955","issn":["1545-5955","1558-3783"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310319808","host_organization_name":"Institute of Electrical and Electronics Engineers","host_organization_lineage":["https://openalex.org/P4310319808"],"host_organization_lineage_names":["Institute of Electrical and Electronics Engineers"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE Transactions on Automation Science and Engineering","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/9","display_name":"Industry, innovation and infrastructure","score":0.49000000953674316}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":45,"referenced_works":["https://openalex.org/W43902372","https://openalex.org/W147964898","https://openalex.org/W588098693","https://openalex.org/W612199005","https://openalex.org/W1813609006","https://openalex.org/W1865339649","https://openalex.org/W1927891414","https://openalex.org/W1949549029","https://openalex.org/W1987661380","https://openalex.org/W1988974262","https://openalex.org/W1991962848","https://openalex.org/W2013612228","https://openalex.org/W2024210334","https://openalex.org/W2027269074","https://openalex.org/W2048520093","https://openalex.org/W2050108201","https://openalex.org/W2079970626","https://openalex.org/W2090584059","https://openalex.org/W2094712627","https://openalex.org/W2112038757","https://openalex.org/W2131026136","https://openalex.org/W2141683982","https://openalex.org/W2147090137","https://openalex.org/W2152469069","https://openalex.org/W2155241186","https://openalex.org/W2181529788","https://openalex.org/W2193989556","https://openalex.org/W2195768472","https://openalex.org/W2203273726","https://openalex.org/W2214332123","https://openalex.org/W2260696694","https://openalex.org/W2275677704","https://openalex.org/W2311585764","https://openalex.org/W2324925980","https://openalex.org/W2409297354","https://openalex.org/W2419651799","https://openalex.org/W2516931333","https://openalex.org/W2547736127","https://openalex.org/W2561295702","https://openalex.org/W2592289816","https://openalex.org/W2621140274","https://openalex.org/W2736131851","https://openalex.org/W4232414536","https://openalex.org/W6601761347","https://openalex.org/W6694486873"],"related_works":["https://openalex.org/W2595172197","https://openalex.org/W2084856301","https://openalex.org/W2127970246","https://openalex.org/W4382618745","https://openalex.org/W2885125400","https://openalex.org/W1001352512","https://openalex.org/W1989889224","https://openalex.org/W2748922771","https://openalex.org/W1987128138","https://openalex.org/W2743976221"],"abstract_inverted_index":{"Reducing":[0],"delays":[1],"between":[2],"primary":[3,67],"care":[4,7,16,27,37,68,71,185],"and":[5,30,40,74,83,95,123,156,172,183],"specialty":[6,70],"visits":[8],"is":[9,38,59,89,128,145],"critical":[10,134],"to":[11,34,60,69,78,91,117,130,147,176,180],"improving":[12],"continuity":[13],"of":[14,47,56,98,110,150,162],"ambulatory":[15],"delivery.":[17,186],"To":[18],"comply":[19],"with":[20],"referral":[21,72,111,121,139],"protocols,":[22],"personnel":[23,100],"involved":[24,99],"in":[25],"patients'":[26,66],"pathways":[28],"process":[29,88],"record":[31],"pertinent":[32],"information":[33,43,63,93,166,178],"ensure":[35],"appropriate":[36],"rendered,":[39],"missing":[41],"necessary":[42],"might":[44],"cause":[45],"\u201cdropping":[46],"the":[48,51,62,80,96,119,132,138,148,157,160,177],"baton\u201d":[49],"during":[50],"patient":[52],"transition.":[53],"The":[54,141],"objective":[55],"this":[57],"paper":[58],"analyze":[61],"flow":[64],"along":[65],"pathway,":[73],"identify":[75,131],"system":[76,167,179],"bottlenecks":[77],"enhance":[79],"workflow":[81],"design":[82],"workforce":[84],"configuration.":[85],"A":[86],"semi-Markov":[87],"introduced":[90],"describe":[92],"transition":[94],"operations":[97],"are":[101,115],"modeled":[102],"as":[103],"capacity-constrained":[104],"service":[105],"queues":[106],"at":[107],"every":[108],"stage":[109],"pathway.":[112],"Analytical":[113],"formulas":[114],"derived":[116],"evaluate":[118],"overall":[120],"delay,":[122],"a":[124,151,164],"continuous":[125],"improvement":[126],"method":[127],"developed":[129],"most":[133],"factor":[135],"that":[136,168],"impedes":[137],"process.":[140],"proposed":[142],"systems":[143],"approach":[144],"applied":[146],"clinics":[149],"large":[152],"academic":[153],"medical":[154],"center,":[155],"analysis":[158],"stresses":[159],"importance":[161],"building":[163],"health":[165],"supports":[169],"breaking":[170],"silos":[171],"adapting":[173],"providers'":[174],"workflows":[175],"facilitate":[181],"smart":[182],"connected":[184]},"counts_by_year":[{"year":2025,"cited_by_count":1},{"year":2022,"cited_by_count":3},{"year":2019,"cited_by_count":1}],"updated_date":"2026-08-21T09:56:20.448147","created_date":"2025-10-10T00:00:00"}
